TMS Fee Schedule
Please note that the fee schedules below are by no means a comprehensive list. The majority of appointments utilize the codes and fee structure above, though changes may occur depending on the complexity or type of appointment. We will do our best to discuss such changes with you ahead of time.
Fee Schedule – Dr. Jared Dalton
| CODE | SERVICE DESCRIPTION | FEE |
|---|---|---|
| 90867 | Therapeutic Repetitive Transcranial Magnetic Stimulation (TMS)-Initial cortical mapping, motor threshold determination, delivery and management | $700 |
| 90868 | TMS Treatment with subsequent delivery and management, per session | $500 |
| 90869 | TMS Treatment including subsequent motor threshold re-determination with delivery and management | $700 |
| 90867 | TMS Theta Burst- Initial cortical mapping, motor threshold determination, delivery and management | $250 |
| 90868 | TMS Theta Burst with subsequent delivery and management, per session | $50 |
| 90869 | TMS Theta Burst Treatment including subsequent motor threshold re-determination with delivery and management | $250 |
| Records Request | Record Retrieval | $25 + $.25/page over 10 pages |
| Records Request | Record Retrieval 1-2 day Service | $35 + $.25/page over 10 pages |
| Court Fees | Prep Time (billed in 15 min increments)** | $200/hr |
| Court Fees | Court Time (minimum of 4 hours)** | $400/hr |
| Missed Appointment Fee | $30 for first and $100 for each additional |
Fee Schedule – Autumn Sheese, ACNP-BC
| CODE | SERVICE DESCRIPTION | FEE |
|---|---|---|
| 90867 | Therapeutic Repetitive Transcranial Magnetic Stimulation (TMS)-Initial cortical mapping, motor threshold determination, delivery and management | $700 |
| 90868 | TMS Treatment with subsequent delivery and management, per session | $500 |
| 90869 | TMS Treatment including subsequent motor threshold re-determination with delivery and management | $700 |
| 90867 | TMS Theta Burst- Initial cortical mapping, motor threshold determination, delivery and management | $250 |
| 90868 | TMS Theta Burst with subsequent delivery and management, per session | $50 |
| 90869 | TMS Theta Burst Treatment including subsequent motor threshold re-determination with delivery and management | $250 |
| 90792 | (Spravato) Initial Assessment by Nurse Practitioner | $250 |
| 99215 99417 96127 | Spravato Monitoring | $190 $50/unit $15/Unit |
| Records Request | Record Retrieval | $25 + $.25/page over 10 pages |
| Records Request | Record Retrieval 1-2 day Service | $35 + $.25/page over 10 pages |
| Court Fees | Prep Time (billed in 15 min increments)** | $200/hr |
| Court Fees | Court Time (minimum of 4 hours)** | $400/hr |
| Missed Appointment Fee | $30 for first and $100 for each additional |